Attrition and adherence of young women to aerobic exercise: Lessons from the WISER study

Abstract

The purpose of this report is to identify factors associated with attrition and adherence of young women to a 16-week randomized aerobic exercise intervention on biomarkers associated with breast cancer risk. The exercise group was prescribed a progressive weight-bearing aerobic exercise program consisting of 30 minute workouts, 5 times/wk for 16 weeks. Adherence was calculated as the average minutes of exercise per week during participation in the study. Of the total of 212 women randomized into the exercise intervention 46 dropped out, of which 82.5% dropped out during the earlier stages of exercise suggesting that reasons for withdrawal may have been related to difficulties with initiating physical activity. Time commitment or lack of time was the primary reason for withdrawal. Drop outs reported lower physical activity at baseline than study completers (p=.0007). Although 78% of the 212 randomized participants completed the exercise intervention, only 4.7% of the participants exercised for at least 150 min/wk during the entire study period. Significant predictors of adherence were self-reported physical activity at baseline and depression scores. We conclude that predictors of adherence to exercise in our population of young women are similar to those reported for older adults. We also found that young women are more likely to exercise at moderate to vigorous intensity for 90 to 120 minutes rather than 150 minutes per week, even when participating in a highly structured exercise intervention.

Effectiveness of a 12-month randomized clinical trial to increase physical activity in multiethnic postpartum women: Results from Hawaii's Nā Mikimiki Project

“…(Linke, Gallo, & Norman, 2011; Moroshko, Brennan, & O'Brien, 2011; Neve, Collins, & Morgan, 2010; Peels et al, 2012) Nonetheless, future physical activity interventions should make every effort to retain participants with, for example, a higher BMI at baseline, by including strategies/messages that directly address issues important to this subgroup (i.e., being physically active is important regardless of how much you weigh or whether you are trying to lose weight or not). Also, lower retention rates for ethnic minorities in randomized clinical trials are a concern;(Arikawa, O'Dougherty, Kaufman, Schmitz, & Kurzer, 2012; Moroshko et al, 2011; Murphy & Williams, 2013; Osann et al, 2011) however, we used several strategies that have been shown to maximize retention in clinical trials (i.e., establishing rapport, participants’ perception of the study as informative, etc. )(Barnett, Aquilar, Brittner, & Bonuck, 2012; D.…”

No Effect of Exercise on Urinary 6-Sulfatoxymelatonin and Catecholamines in Young Women Participating in a 16-Week Randomized Controlled Trial

“…It is also possible that the duration and intensity of the exercise training in this study was not sufficient to alter SNS activity and thus change melatonin levels. Strengths of this trial include excellent adherence to the exercise treatment (7), large sample size, and selecting an exercise intervention based on current public health guidelines (8). …”

Life events, perceived stress and depressive symptoms in a physical activity intervention with young adult women

“…In our study, all exercise participants who completed follow up measurements had adherence levels of 80% or above, as calculated by the average minutes of exercise that participants reported as having completed per week for each of the four stages of exercise intensity. Analysis of study adherence and withdrawal was the subject of a separate examination (Arikawa et al, 2012). Most research has shown an inverse relationship between depressive symptoms and physical activity (e.g., Dunn 2005), as well as between perceived stress and physical activity (Aldana, 1996).…”